by Traci Chapman – Writer/Photographer
Nicki Cerne is a nurse who not only wears a lot of hats, she has a lot of patients – nearly 2,900 of them.
Those patients are the students of El Reno Public Schools. As the western Canadian County school district’s director of nursing – and its sole nurse – Cerne cares for prekindergarten through high school seniors, dealing with everyday scrapes and medication questions, training staff in first aid and other health issues.
But, as with many other school nurses, there is much more to it than meets the eye – then, consider she is the single point of contact for more than 2,800 students, their families, teachers, administrators and personnel and the community overall and it’s a job many people might run from.
Not Cerne, El Reno Superintendent Craig McVay said.
“We are so incredibly lucky to have Nicki Cerne on our staff as the director of nursing,” McVay said. “Nicki has a passion for helping students and continues to amaze all of us with her level of expertise on best practices for pediatric nursing in all areas.”
Cerne’s varied experience was a plus as she began tackling the ERPS nursing director job.
After nursing school, she first worked at Select Specialty Hospital Medical/Surgical and ICU, as well as a more than three-year stint working hospice, where she started an OU Children’s Hospital pediatric hospice division, she said.
That experience – as well as about a year working PRN for Preferred Pediatrics – marked a change in both Cerne’s outlook and where she wanted to take her career. Mother to a 19-year-old and twin 17-year-old daughters, Cerne said she was increasingly pulled toward working with children.
That’s how she became a public health nurse for Canadian County Health Department. There, she was responsible for El Reno Public Schools, as part of a contract between the two entities; when budget cuts slashed the department’s school nurse program, McVay hired Cerne to take over the district position.
But, actual hands on nursing was only part of that position, Cerne said. Working directly for ERPS was very different from her contractual responsibilities, and the new nursing director jumped in with both feet, McVay said.
“Especially in the area of prevention…I can’t tell you how many times I’ve watched or heard her with kids and co-workers talking about ways to prevent the spread of all the nasty kinds of stuff that hangs around schools,” he said. “Nicki easily made the transition (to full-time ERPS director of nursing), and really it has been like she was one of our staff the whole time anyway.”
To Cerne that transition meant coming up to speed on a variety of issues, first concentrating on areas that could most adversely affect students. With hundreds of the almost 2,900 children and youth attending ERPS facing potentially life-threatening conditions like seizures, asthma, anaphylactic reactions and diabetes, Cerne created individual medical files for those dealing with those issues – one copy for her and the other for school site administrators and each teacher who oversaw that student.
“I wanted to make sure everyone had the most up-to-date and complete information possible about what a particular student might be dealing with and how to address it, should an emergency arise,” the nursing director said. “While I go to each school site and usually can be there very quickly, as can emergency personnel, a lot of times the first level of defense is going to be a teacher, principal or school secretary.”
Wrapping up that first-tier project, Cerne then turned to other items that could impact a student, developing a site-by-site list including any information pertinent to a child’s well-being. She manually entered that data into the district’s districtwide computer software, PowerSchool – a months’ long process – so it could be both easily accessed and updated as needed.
“We have all kinds of things, whether it’s a student recovering from cancer or someone with heart issues, ADHD, or a student might be in the hospital,” she said. “I had each student and their family fill out a form that helps make sure we’re completely up-to-date on anything they’re dealing with, from the routine to the most specialized situation.”
In a district where about 80 percent of its students qualify for free and reduced lunches and with a much higher than usual special needs population, Cerne’s care – and her attention to the minutest of details when it comes to not only the known conditions of her students, but also preventative medicine and screenings that could uncover hidden issues – is even more crucial.
And, it’s made a difference, administrators said.
Most recently, ERPS completed annual vision and hearing screenings for its kindergarten through second-grade students. One of those tests uncovered something startling for Cerne and for teachers and administrators at Rose Witcher Elementary School, when they discovered a second-grader there was totally deaf.
“No one knew this – not the parents, not his teachers, just no one,” Cerne said. “To me, that’s why what we do is so important – that is one kid who would have gotten lost in the system.”
Educators agreed. In fact, one district elementary teacher told Cerne just days after vision screenings were done on her class, seven students showed up wearing glasses.
“Think what that means for those students, who could have been marked as ‘problems’ because they couldn’t achieve what they’re capable of, simply because they couldn’t see properly,” Cerne said. “That’s one of the things that gives me so much satisfaction about what we’re doing here.”
Those types of results – and the fact many ERPS families struggle just to keep a roof over their children’s heads – led also to the “Smile, It’s Healthy” program, a partnership with a Fairway, Kansas, company that provides free dental care to students districtwide.
“They provide exams, cleanings, x-rays and fluoride treatments, coming out twice a year in the spring and fall, and they can come back after initial screenings to fill cavities – or they can refer the student to a local dentist,” Cerne said. “This can be so important for families who can’t afford expensive dental care, because SmileIH bills SoonerCare or provides free care to those who don’t have that or don’t have dental insurance.
“With dental issues having such a long-range impact on someone’s health, this is just invaluable to our students,” she said.
Up next for Cerne and her district are expanded efforts to address yet another rarely discussed medical challenge – students’ anxiety and mental health issues.
“We have several students who have – sometimes severe – PTSD, and others who deal with extreme anxiety and other issues that no one talks about,” Cerne said. “There are no programs to address this, and unless the behavior is so over the top that student can face it all alone.
“Some of these kids, what they have to deal with just to get to school, is overwhelming, so it’s imperative we have more education, more communication and more understanding so we can help them when it’s early, when they’re younger and it can really help them, not just through their school lives, but also beyond,” she said.
Cerne’s dedication has inspired others in the district to help each new program and effort the nursing director has taken on – from on-the-ground screenings and care to implementing district policy changes to make sure everything from immunizations to access to care are ensured for everyone, administrators said.
“She’s a real pediatric nursing professional and we are blessed she is serving our kids every day,” superintendent McVay said.
The work is a long way from her years growing years growing up in a Denver, Colorado, suburb and original arts and sciences degrees she earned – but, it’s something she would never give up now, Cerne said.
“I never saw myself working with kids, but I just love them, love how they see things and how smart they are – it always saddens me when people just think ‘they are kids and don’t know anything,’ because if you ever sit down with kids from five years to 18 and just have a conversation, you can learn so much,” she said. “Special need kids always have a special place in my heart, I think because of my dad who had CP, but we never treated him any different from anyone else.
“I would see people look at him because of the way he walked, and I would think, ‘you don’t even know him’ – and it made me work hard not to judge anyone by how they look or by what other people might think of them,” Cerne said. “Every one of these students, no matter what they face or how they might start out, have the potential to offer so much, and if I can make sure they have the chance to do that, it’s worth it every single time.”